MARK STEVEN WALLACE MD - Medical Doctor License in Missouri | # 036089547

MARK STEVEN WALLACE MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036089547

License Status

INACTIVE

Business

N

First Name

MARK STEVEN

Last Name

WALLACE

Suffix

MD

Business Name

MARK STEVEN WALLACE MD

Original Issue Date

08/26/1994

Effective Date

07/31/2006

Expiration Date

07/31/2008

State

MO

Ever Disciplined

N

LastModifiedDate

04/17/2008